Melasma – Photo Credit: Wikimedia
Melasma is a darkening of areas of the skin, most often on the face, chest, uncommonly, the arms and neck. It is found most often in women, especially women of color, and is so common during pregnancy that its other name is “the mask of pregnancy.” Very few men get melasma.
Melasma Causes
Doctors aren’t exactly sure what the causes of melasma are, but they believe that one reason is a surge in melanin production. Melanin is the pigment that gives skin its color. Melasma is more common in dark-skinned people than those with fair skin because they have more melanin in their skin. Suspected melasma causes are:
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Hormone Levels
The surging hormone levels during pregnancy and even in women who are taking birth control pills or one replacement therapy seem to ramp up the production of melanin. Because the skin can’t quite handle the surge, it sends melanin to some regions of the body, and melasma on the face is the most common result. This particular type of melasma is called chloasma.
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Exposure to the sun
Melanin is stimulated by the sun’s ultraviolet rays. Indeed, if a person who already has melasma goes sunbathing, they will make their melasma worse. The condition may even progress to the point where the darker “stains” fade but don’t entirely go away.
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Use of Skin Care Products
Some skin care products irritate the skin of some people and make their melasma worse.
Melasma Symptoms
Melasma is painless, but the people who have the condition dislike how it makes them look, especially if they have melasma on the face. This can affect their self-esteem. Melasma is one reason that patients, especially women, go to their dermatologist or aesthetician for treatment.
Top Melasma Treatments Include:
Topical Medications
Melasma can be addressed in a variety of ways. Some doctors prescribe lightening creams, lotions or gels including those that contain hydroquinone. This topical treatment needs to be used until the skin is lightened, which may take about a month. The patient needs to stay out of the sun during that time or use a strong sunscreen if they must go out into the sunlight. Hydroquinone interferes with the action of melanocytes, which are skin cells that contain melanin. It does not allow these skin cells to produce as much melanin.
Hydroquinone is often used in conjunction with tretinoin, a skin care product that’s derived from vitamin A. Tretinoin exfoliates the stratum corneum, which is the top layer of skin where dead skin cells are found. This allows the body to bring new, fresh skin cells to the top layer of the skin. Dermatologists recommend that tretinoin be used at night since it increases the patient’s sensitivity to the sun’s ultraviolet rays. As was discussed, UV rays worsen melasma.
Other tropical medications the doctor can prescribe to treat melasma are corticosteroids and azelaic or kojic acid. Derived from grains such a wheat and barley, azelaic acid is an anti-inflammatory that calms the skin down. It also has anti-bacterial qualities. Kojic acid is a skin lightener, and like hydroquinone, it disrupts the melanocytes ability to produce melanin.
Minimally Invasive Treatments
If topical treatments don’t work, the patient can opt for minimally invasive treatments such as microdermabrasion, dermabrasion or chemical peels.
In dermabrasion, the top layers of the skin are exfoliated with a diamond burr. Microdermabrasion works the same way, but more gently. It exfoliates the skin with a stream of crystals.
If the patient opts for a chemical peel, the doctor paints their face with an alpha hydroxy acid such a glycolic acid. These acids are also called fruit acids because they are often derived from plants. Glycolic acid, for example, is derived from sugar cane. Laser treatments use laser light to destroy the pigment in the skin, as does exposure to certain lights. These treatments should only be done by a dermatologist, for a dermatologist is able to tailor the treatment to the patient’s skin type.